MEDICARE: FLORIDA INSTITUTE OF HEALTH LTD LLLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	ME0041465	FL
2	207RC0000X	Cardiovascular Disease Physician	ME0041465	FL

General Provider Information

NPI Number	:	1750378949
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FLORIDA INSTITUTE OF HEALTH LTD LLLP

Provider Business Mailing Address
First Line	:	4850 W OAKLAND PARK BLVD
Second Line	:	SUITE 205
City	:	LAUDERDALE LAKES
State	:	FL
Zip	:	33313-7260
Country	:	US
Telephone Number	:	954-484-7030
Fax Number	:	954-484-1280

Provider Business Practice Location Address
First Line	:	7301 N UNIVERSITY DR
Second Line	:	SUITE 204
City	:	TAMARAC
State	:	FL
Zip	:	33321-2919
Country	:	US
Telephone Number	:	954-726-2116
Fax Number	:	954-726-0411

Authorized Official
Title or Position	:	ADMNISTRADOR
Name	:	AVA ZAKEN
Credential	:
Telephone Number	:	954-484-7030

Provider Enumeration Date	:	10/03/2005
Last Update Date	:	10/29/2007

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Directions to “FLORIDA INSTITUTE OF HEALTH LTD LLLP ” Practice Location

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